Facilitators and barriers to support group participation for family caregivers of adults with mental illness

Few low-income and minority caregivers of persons with serious mental illness participate in support groups. This study examined the facilitators and barriers to participation in support groups for families of persons with serious mental illness among lower socioeconomic African-American and Caucasi...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Community mental health journal 2004-04, Vol.40 (2), p.151-166
Hauptverfasser: BIEGEL, David E, SHAFRAN, Robert D, JOHNSEN, Jeffrey A
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 166
container_issue 2
container_start_page 151
container_title Community mental health journal
container_volume 40
creator BIEGEL, David E
SHAFRAN, Robert D
JOHNSEN, Jeffrey A
description Few low-income and minority caregivers of persons with serious mental illness participate in support groups. This study examined the facilitators and barriers to participation in support groups for families of persons with serious mental illness among lower socioeconomic African-American and Caucasian family caregivers. Three hypotheses were tested in a multivariate model which included need, enabling and predisposing variables utilizing a revised version of the Andersen model. Support group membership was hypothesized to be predicted by a higher perceived cost-benefit ratio (benefits minus costs) of group participation, fewer numbers of access barriers and higher levels of service use. A non-experimental cross-sectional design was used. Subjects were 145 lower socioeconomic status African-American and Caucasian family caregivers, 65 of whom were current support group members and 80 of whom had never participated in support groups. Findings confirmed that support group members reported a more favorable cost-benefit ratio and fewer access barriers than did non-support group members, controlling for other variables. Level of non-support group service use was not significantly different for support and non-support group members. Non-members' assessments of support group participation may be based on inaccurate perceptions and/or incomplete knowledge. Educational campaigns, sponsored by support groups and mental health authorities focusing on both perceptions about support groups as well as structural impediments to participation, such as access barriers, should be undertaken.
doi_str_mv 10.1023/B:COMH.0000022734.79135.de
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_66652371</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>66652371</sourcerecordid><originalsourceid>FETCH-LOGICAL-c403t-f172deececb5405ca122718d9cf5dd445aece135b525b6b4273d8ad5a29baf3a3</originalsourceid><addsrcrecordid>eNqFkUtv1TAQhS0EopfCX0BWJdjl4kccJ93RK0qRirqBtTXxo7hy4mA7Rf33OPRKRWzwZmT5OzM-cxA6o2RPCeMfLs4PN1-v9mQ7jEne7uVAudgb-wztqJC8YbIfnqMdIZQ0vBf8BL3K-a7iglL5Ep1QwUjX8WGHwiVoH3yBElPGMBs8Qkre1kuJOK_LElPBtymuC14gFa_9AsXHGbuYsIPJhwesIdlbf7-JosNg1lAy_uXLDzzZuUDAPoTZ5vwavXAQsn1zrKfo--Wnb4er5vrm85fDx-tGt4SXxlHJjLXa6lG0RGig1SXtzaCdMKZtBdS3angUTIzd2NYVmB6MADaM4DjwU_T-se-S4s_V5qImn7UNAWYb16y6rhOMS_pfUEhSf9TyCp79A97FNc3VhGKs56Tt2Nbt_BHSKeacrFNL8hOkB0WJ2pJTF2pLTj0lp_4kp4yt4rfHCes4WfMkPUZVgXdHALKG4BLM2ue_ONkNRDL-G04RpKg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>228304621</pqid></control><display><type>article</type><title>Facilitators and barriers to support group participation for family caregivers of adults with mental illness</title><source>MEDLINE</source><source>SpringerNature Journals</source><source>Sociological Abstracts</source><source>Applied Social Sciences Index &amp; Abstracts (ASSIA)</source><creator>BIEGEL, David E ; SHAFRAN, Robert D ; JOHNSEN, Jeffrey A</creator><creatorcontrib>BIEGEL, David E ; SHAFRAN, Robert D ; JOHNSEN, Jeffrey A</creatorcontrib><description>Few low-income and minority caregivers of persons with serious mental illness participate in support groups. This study examined the facilitators and barriers to participation in support groups for families of persons with serious mental illness among lower socioeconomic African-American and Caucasian family caregivers. Three hypotheses were tested in a multivariate model which included need, enabling and predisposing variables utilizing a revised version of the Andersen model. Support group membership was hypothesized to be predicted by a higher perceived cost-benefit ratio (benefits minus costs) of group participation, fewer numbers of access barriers and higher levels of service use. A non-experimental cross-sectional design was used. Subjects were 145 lower socioeconomic status African-American and Caucasian family caregivers, 65 of whom were current support group members and 80 of whom had never participated in support groups. Findings confirmed that support group members reported a more favorable cost-benefit ratio and fewer access barriers than did non-support group members, controlling for other variables. Level of non-support group service use was not significantly different for support and non-support group members. Non-members' assessments of support group participation may be based on inaccurate perceptions and/or incomplete knowledge. Educational campaigns, sponsored by support groups and mental health authorities focusing on both perceptions about support groups as well as structural impediments to participation, such as access barriers, should be undertaken.</description><identifier>ISSN: 0010-3853</identifier><identifier>EISSN: 1573-2789</identifier><identifier>DOI: 10.1023/B:COMH.0000022734.79135.de</identifier><identifier>PMID: 15206639</identifier><identifier>CODEN: CMHJAY</identifier><language>eng</language><publisher>New York, NY: Springer</publisher><subject>Adult ; African Americans ; Aged ; Aged, 80 and over ; Barriers ; Biological and medical sciences ; Caregivers ; Caregivers - statistics &amp; numerical data ; Carers ; Communication Barriers ; Community Participation - economics ; Community Participation - statistics &amp; numerical data ; Coping ; Cost-Benefit Analysis ; Costs ; Cross-Sectional Studies ; Facilitators ; Families ; Families &amp; family life ; Family environment. Family history ; Female ; Humans ; Hypotheses ; Male ; Medical personnel ; Medical sciences ; Mental disorders ; Mental Disorders - economics ; Mental Disorders - therapy ; Mental health ; Mental health care ; Mentally ill people ; Middle Aged ; Participation ; Perceptions ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Self-Help Groups ; Social Facilitation ; Social psychiatry. Ethnopsychiatry ; Social services ; Social support ; Socioeconomic Factors ; Socioeconomic status ; Support groups ; Surveys and Questionnaires ; USA ; Variables ; White people</subject><ispartof>Community mental health journal, 2004-04, Vol.40 (2), p.151-166</ispartof><rights>2004 INIST-CNRS</rights><rights>Copyright Kluwer Academic Publishers Apr 2004</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c403t-f172deececb5405ca122718d9cf5dd445aece135b525b6b4273d8ad5a29baf3a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,12846,27344,27924,27925,30999,31000,33774</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=15769072$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15206639$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BIEGEL, David E</creatorcontrib><creatorcontrib>SHAFRAN, Robert D</creatorcontrib><creatorcontrib>JOHNSEN, Jeffrey A</creatorcontrib><title>Facilitators and barriers to support group participation for family caregivers of adults with mental illness</title><title>Community mental health journal</title><addtitle>Community Ment Health J</addtitle><description>Few low-income and minority caregivers of persons with serious mental illness participate in support groups. This study examined the facilitators and barriers to participation in support groups for families of persons with serious mental illness among lower socioeconomic African-American and Caucasian family caregivers. Three hypotheses were tested in a multivariate model which included need, enabling and predisposing variables utilizing a revised version of the Andersen model. Support group membership was hypothesized to be predicted by a higher perceived cost-benefit ratio (benefits minus costs) of group participation, fewer numbers of access barriers and higher levels of service use. A non-experimental cross-sectional design was used. Subjects were 145 lower socioeconomic status African-American and Caucasian family caregivers, 65 of whom were current support group members and 80 of whom had never participated in support groups. Findings confirmed that support group members reported a more favorable cost-benefit ratio and fewer access barriers than did non-support group members, controlling for other variables. Level of non-support group service use was not significantly different for support and non-support group members. Non-members' assessments of support group participation may be based on inaccurate perceptions and/or incomplete knowledge. Educational campaigns, sponsored by support groups and mental health authorities focusing on both perceptions about support groups as well as structural impediments to participation, such as access barriers, should be undertaken.</description><subject>Adult</subject><subject>African Americans</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Barriers</subject><subject>Biological and medical sciences</subject><subject>Caregivers</subject><subject>Caregivers - statistics &amp; numerical data</subject><subject>Carers</subject><subject>Communication Barriers</subject><subject>Community Participation - economics</subject><subject>Community Participation - statistics &amp; numerical data</subject><subject>Coping</subject><subject>Cost-Benefit Analysis</subject><subject>Costs</subject><subject>Cross-Sectional Studies</subject><subject>Facilitators</subject><subject>Families</subject><subject>Families &amp; family life</subject><subject>Family environment. Family history</subject><subject>Female</subject><subject>Humans</subject><subject>Hypotheses</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Medical sciences</subject><subject>Mental disorders</subject><subject>Mental Disorders - economics</subject><subject>Mental Disorders - therapy</subject><subject>Mental health</subject><subject>Mental health care</subject><subject>Mentally ill people</subject><subject>Middle Aged</subject><subject>Participation</subject><subject>Perceptions</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Self-Help Groups</subject><subject>Social Facilitation</subject><subject>Social psychiatry. Ethnopsychiatry</subject><subject>Social services</subject><subject>Social support</subject><subject>Socioeconomic Factors</subject><subject>Socioeconomic status</subject><subject>Support groups</subject><subject>Surveys and Questionnaires</subject><subject>USA</subject><subject>Variables</subject><subject>White people</subject><issn>0010-3853</issn><issn>1573-2789</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>BHHNA</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkUtv1TAQhS0EopfCX0BWJdjl4kccJ93RK0qRirqBtTXxo7hy4mA7Rf33OPRKRWzwZmT5OzM-cxA6o2RPCeMfLs4PN1-v9mQ7jEne7uVAudgb-wztqJC8YbIfnqMdIZQ0vBf8BL3K-a7iglL5Ep1QwUjX8WGHwiVoH3yBElPGMBs8Qkre1kuJOK_LElPBtymuC14gFa_9AsXHGbuYsIPJhwesIdlbf7-JosNg1lAy_uXLDzzZuUDAPoTZ5vwavXAQsn1zrKfo--Wnb4er5vrm85fDx-tGt4SXxlHJjLXa6lG0RGig1SXtzaCdMKZtBdS3angUTIzd2NYVmB6MADaM4DjwU_T-se-S4s_V5qImn7UNAWYb16y6rhOMS_pfUEhSf9TyCp79A97FNc3VhGKs56Tt2Nbt_BHSKeacrFNL8hOkB0WJ2pJTF2pLTj0lp_4kp4yt4rfHCes4WfMkPUZVgXdHALKG4BLM2ue_ONkNRDL-G04RpKg</recordid><startdate>20040401</startdate><enddate>20040401</enddate><creator>BIEGEL, David E</creator><creator>SHAFRAN, Robert D</creator><creator>JOHNSEN, Jeffrey A</creator><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7RV</scope><scope>7U3</scope><scope>7WY</scope><scope>7WZ</scope><scope>7X7</scope><scope>7XB</scope><scope>87Z</scope><scope>88E</scope><scope>88G</scope><scope>88J</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FL</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BEZIV</scope><scope>BHHNA</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FRNLG</scope><scope>FYUFA</scope><scope>F~G</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HEHIP</scope><scope>K60</scope><scope>K6~</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>L.-</scope><scope>M0C</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2R</scope><scope>M2S</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQBIZ</scope><scope>PQBZA</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20040401</creationdate><title>Facilitators and barriers to support group participation for family caregivers of adults with mental illness</title><author>BIEGEL, David E ; SHAFRAN, Robert D ; JOHNSEN, Jeffrey A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c403t-f172deececb5405ca122718d9cf5dd445aece135b525b6b4273d8ad5a29baf3a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>African Americans</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Barriers</topic><topic>Biological and medical sciences</topic><topic>Caregivers</topic><topic>Caregivers - statistics &amp; numerical data</topic><topic>Carers</topic><topic>Communication Barriers</topic><topic>Community Participation - economics</topic><topic>Community Participation - statistics &amp; numerical data</topic><topic>Coping</topic><topic>Cost-Benefit Analysis</topic><topic>Costs</topic><topic>Cross-Sectional Studies</topic><topic>Facilitators</topic><topic>Families</topic><topic>Families &amp; family life</topic><topic>Family environment. Family history</topic><topic>Female</topic><topic>Humans</topic><topic>Hypotheses</topic><topic>Male</topic><topic>Medical personnel</topic><topic>Medical sciences</topic><topic>Mental disorders</topic><topic>Mental Disorders - economics</topic><topic>Mental Disorders - therapy</topic><topic>Mental health</topic><topic>Mental health care</topic><topic>Mentally ill people</topic><topic>Middle Aged</topic><topic>Participation</topic><topic>Perceptions</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Self-Help Groups</topic><topic>Social Facilitation</topic><topic>Social psychiatry. Ethnopsychiatry</topic><topic>Social services</topic><topic>Social support</topic><topic>Socioeconomic Factors</topic><topic>Socioeconomic status</topic><topic>Support groups</topic><topic>Surveys and Questionnaires</topic><topic>USA</topic><topic>Variables</topic><topic>White people</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BIEGEL, David E</creatorcontrib><creatorcontrib>SHAFRAN, Robert D</creatorcontrib><creatorcontrib>JOHNSEN, Jeffrey A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Applied Social Sciences Index &amp; Abstracts (ASSIA)</collection><collection>Nursing &amp; Allied Health Database</collection><collection>Social Services Abstracts</collection><collection>ABI/INFORM Collection</collection><collection>ABI/INFORM Global (PDF only)</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ABI/INFORM Global (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ABI/INFORM Collection (Alumni Edition)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Business Premium Collection</collection><collection>Sociological Abstracts</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Business Premium Collection (Alumni)</collection><collection>Health Research Premium Collection</collection><collection>ABI/INFORM Global (Corporate)</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>Sociology Collection</collection><collection>ProQuest Business Collection (Alumni Edition)</collection><collection>ProQuest Business Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>ABI/INFORM Professional Advanced</collection><collection>ABI/INFORM Global</collection><collection>Consumer Health Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Social Science Database</collection><collection>Sociology Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest One Business</collection><collection>ProQuest One Business (Alumni)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Community mental health journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BIEGEL, David E</au><au>SHAFRAN, Robert D</au><au>JOHNSEN, Jeffrey A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Facilitators and barriers to support group participation for family caregivers of adults with mental illness</atitle><jtitle>Community mental health journal</jtitle><addtitle>Community Ment Health J</addtitle><date>2004-04-01</date><risdate>2004</risdate><volume>40</volume><issue>2</issue><spage>151</spage><epage>166</epage><pages>151-166</pages><issn>0010-3853</issn><eissn>1573-2789</eissn><coden>CMHJAY</coden><abstract>Few low-income and minority caregivers of persons with serious mental illness participate in support groups. This study examined the facilitators and barriers to participation in support groups for families of persons with serious mental illness among lower socioeconomic African-American and Caucasian family caregivers. Three hypotheses were tested in a multivariate model which included need, enabling and predisposing variables utilizing a revised version of the Andersen model. Support group membership was hypothesized to be predicted by a higher perceived cost-benefit ratio (benefits minus costs) of group participation, fewer numbers of access barriers and higher levels of service use. A non-experimental cross-sectional design was used. Subjects were 145 lower socioeconomic status African-American and Caucasian family caregivers, 65 of whom were current support group members and 80 of whom had never participated in support groups. Findings confirmed that support group members reported a more favorable cost-benefit ratio and fewer access barriers than did non-support group members, controlling for other variables. Level of non-support group service use was not significantly different for support and non-support group members. Non-members' assessments of support group participation may be based on inaccurate perceptions and/or incomplete knowledge. Educational campaigns, sponsored by support groups and mental health authorities focusing on both perceptions about support groups as well as structural impediments to participation, such as access barriers, should be undertaken.</abstract><cop>New York, NY</cop><pub>Springer</pub><pmid>15206639</pmid><doi>10.1023/B:COMH.0000022734.79135.de</doi><tpages>16</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0010-3853
ispartof Community mental health journal, 2004-04, Vol.40 (2), p.151-166
issn 0010-3853
1573-2789
language eng
recordid cdi_proquest_miscellaneous_66652371
source MEDLINE; SpringerNature Journals; Sociological Abstracts; Applied Social Sciences Index & Abstracts (ASSIA)
subjects Adult
African Americans
Aged
Aged, 80 and over
Barriers
Biological and medical sciences
Caregivers
Caregivers - statistics & numerical data
Carers
Communication Barriers
Community Participation - economics
Community Participation - statistics & numerical data
Coping
Cost-Benefit Analysis
Costs
Cross-Sectional Studies
Facilitators
Families
Families & family life
Family environment. Family history
Female
Humans
Hypotheses
Male
Medical personnel
Medical sciences
Mental disorders
Mental Disorders - economics
Mental Disorders - therapy
Mental health
Mental health care
Mentally ill people
Middle Aged
Participation
Perceptions
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Self-Help Groups
Social Facilitation
Social psychiatry. Ethnopsychiatry
Social services
Social support
Socioeconomic Factors
Socioeconomic status
Support groups
Surveys and Questionnaires
USA
Variables
White people
title Facilitators and barriers to support group participation for family caregivers of adults with mental illness
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T17%3A16%3A55IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Facilitators%20and%20barriers%20to%20support%20group%20participation%20for%20family%20caregivers%20of%20adults%20with%20mental%20illness&rft.jtitle=Community%20mental%20health%20journal&rft.au=BIEGEL,%20David%20E&rft.date=2004-04-01&rft.volume=40&rft.issue=2&rft.spage=151&rft.epage=166&rft.pages=151-166&rft.issn=0010-3853&rft.eissn=1573-2789&rft.coden=CMHJAY&rft_id=info:doi/10.1023/B:COMH.0000022734.79135.de&rft_dat=%3Cproquest_cross%3E66652371%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=228304621&rft_id=info:pmid/15206639&rfr_iscdi=true